While living with diabetes can pose a number of challenges, as long as it is managed conscientiously, most people with the disease can lead full lives. And that includes following where their hearts lead. In most instances, all it takes to make traveling pleasurable and reasonably worry-free is a bit of thought and careful planning.
Your primary goal in charting your trip is to minimize your chances of becoming ill or injured while away from home. That means anticipating any disease-related risks. Your destination will have much to do with the plans you make as well as the risks you assume — some places, developing countries for example, are more likely to present problems. The length of your trip and the types of accommodations you make are also important factors to weigh as you make your plans. Nevertheless, if you take sensible precautions, you will, more than likely, be able to stay healthy and enjoy your adventure.
Before any long trip, schedule a medical exam and consultation with your doctor. He or she will make sure that your diabetes is under control and, if not, will help you get it under control before you leave. Discuss your immunization history with your doctor. Appropriate immunizations not only protect you from disease, but some countries require certain immunizations to protect their own citizens from imported diseases. If you anticipate that you will need vaccinations, make sure there is enough time to recuperate before the trip, should the shots make you sick.
Assembling A Travel Folder
With your doctor’s help, put together a travel folder containing all medical and other relevant information. Be sure to label it with your name, address, phone number, doctor’s name and number as well as an emergency contact number. Include the following:
- A complete travel itinerary.
- A detailed description of how to manage your diabetes, whether with pills or insulin injections; the number of syringes, other medications and devices you use. List any allergies you have as well as any foods or medications to which you are sensitive.
- A prescription for insulin or diabetes pills in case of emergency.
- A general health report, including lab tests and results within the past six months; your most recent chemistry profile; most recent electrocardiogram and urinalysis; immunization records; summary of hospitalizations, surgeries, and the like.
- A copy of your American Diabetes Association affiliate Identity Card — perhaps written in major languages. Keep the original in your wallet and perhaps another copy in your travel bag.
- If you’re traveling in the United States, a list of American Diabetes Association affiliates or chapters; they can provide referrals to appropriate health professionals in most areas of the country.
- If you’re traveling in a foreign country, a list of organizations and medical groups affiliated with the International Diabetes Federation can be especially important if you need help in understanding prescription laws and standards in other countries You can get this list from:
International Diabetes Federation 1 rue Defacqz B-1000 Brussels
Also, you can get a list of English-speaking foreign doctors from:
International Association for Medical Assistance to Travellers 417 Center Street
Lewiston, NY 14092
No matter where you are traveling, always wear a medical ID bracelet or necklace.
Pack more than enough insulin and syringes or pills to last through the trip; at least twice as much as you think you’ll need is a good place to start. This recommendation goes for blood-testing supplies as well. Pack half in a bag you can keep with you when you’re flying, hiking or just sightseeing so that your medication is with you at all times.
In general, you’ll need:
- Insulin and syringes and/or oral medications. If you’re traveling with someone else, ask your companion to carry duplicate supplies. Consider bringing an extra set of unopened insulin vials, in the event one breaks.
- Blood- and urine-testing supplies (including extra batteries for your glucose meter).
- Other medications or medical supplies, such as glucagon, antidiarrhea and antinausea medication, antibiotic ointment.
- Your ID and diabetes identity card. Make copies to keep in your carry-on bag and in your suitcase in case one gets lost.
- A supply of small juice packs, fruit, well-wrapped crackers, cheese, peanut butter, and some form of sugar (hard candy or glucose tablets that won’t melt or get sticky) to treat low blood glucose. You never know when a meal will be delayed or you’ll be stuck someplace.
- Water bottles.
- Perhaps a cell phone.
Traveling With Insulin
Although insulin does not need to be refrigerated, it should never be stored in places where it is exposed to extreme temperature. Temperatures that are very hot or very cold can diminish its potency. Therefore, avoid leaving your insulin in the trunk or glove compartment of your car, and don’t leave your backpack or travel bag in the direct sunlight. Consider bringing a padded or insulated travel pack to protect your insulin.
Getting From Here To There
No matter how you travel, being stationary for too long can cause problems with your circulation. Move about as much as possible. If you are traveling by car, stop regularly and take a short walk. On a plane or train, stroll up and down the aisles. On a bus, get out when the bus stops.
Traveling By Air
Some people worry that, as they go through security, the X-rays will affect their glucose meter or insulin. There’s seldom a problem, but if you have any concern, ask to have your carry-on bag hand-inspected.
On long flights, it is also a good idea to order special meals for the plane that are low in sugar, fat or cholesterol. However, be sure to ask at least two days before the flight; otherwise, the airline may not have sufficient time to honor the request. Avoid dietetic meals, which are usually low-carbohydrate meals designed for weight loss.
Be careful if you have to inject insulin while in the air. It’s more likely that you will inject air into the vial. And because the pressurized atmosphere can cause resistance in the plunger, precise measuring can be more difficult.
Don’t take your insulin until you are about to be served your meal. Service is typically slower than anticipated, and a delay or mix-up can cause a precipitous drop in blood glucose.
Measure your blood glucose level as soon as you can upon landing. Because a long flight usually disturbs your normal routine, expect your blood sugar to be somewhat high.
Crossing Time Zones
Although seldom a consideration under different circumstances, when you have diabetes, crossing time zones takes on a whole new dimension. Talk to your doctor, with flight schedule in hand, so that you can plan the timing of your insulin injections when you travel. If you are traveling east, the day will be shorter, so you may need less insulin. If your are traveling west, the day will be longer, so you may need more insulin. Be sure to keep track of your meals and injections as you pass from one time zone to another. And to be on the safe side, do not change your watch to the new time until the morning after your arrival.
If you are traveling abroad, carry the address of the American Consulate in the countries you’ll visit in case you experience a medical emergency. You also can contact American Express or the local medical schools for a list of doctors.
Learn how to say “I have diabetes” or to ask for sugar or orange juice in the appropriate language.
While the standard strength of insulins used in the United States is U-100, in other countries, insulins may come as U-40 or U-80. If you need to use these, you will need to buy appropriate syringes so that you don’t make a mistake in your dosage.
After a long flight, take it slow the first day or so and make sure you have time to rest. Plan your activities around your insulin and meals, and check your blood glucose levels often. Don’t forget to bring snacks wherever you go. Watch what you eat and drink when traveling. Drink bottled water and avoid tap water — including ice cubes — when you are overseas.
Other rules of self-care apply even when you’re on vacation. As always, watch your feet. Don’t wear new shoes, and check your feet daily. Tend to any blister with a mild antiseptic and cover with a small gauze pad held in place with nonallergic tape. Resist the temptation to break blisters. Be careful not to walk barefoot on hot beach sand or in areas where you can cut your feet. Instead, wear beach or water slippers or sandals at all times.
Perhaps the most important tip: With all this planning and preparation, don’t forget to have a good time.